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Zhou H, Han D, Zhou H, Ke X, Jiang D. Influencing factors of psychological pain among older people in China: A cross-sectional study. Heliyon 2023; 9:e21141. [PMID: 37916102 PMCID: PMC10616401 DOI: 10.1016/j.heliyon.2023.e21141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 10/02/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023] Open
Abstract
Limited research has focused on the psychological pain among older people and factors associated with psychological distress in older adults also remain to be evaluated. This study aims to examine the status and correlates of psychological pain among older people from urban and rural areas in China. This cross-sectional study analyzed data from 4312 samples which extracted from the dataset of China's Health-Related Quality of Life Survey for Older Adults 2018. Psychological pain was assessed by the Chinese version of the Psychache Scale (PAS). Multiple linear regression models were established to examine the associations between demographic characteristics and psychological pain. The average score of PAS among older people was 41.79 ± 14.52, and the average score of PAS among urban older people was higher than rural ones in this study. For rural older people, age (B ≥ 80 = 2.55), gender (B Female = 1.27), educational level (B Primary school = 1.63; B ≥ Middle school = 0.27), smoking (B yes = 0.83), number of chronic diseases (B ≥ 2 = 3.19) and personal social capital (B BRC = 0.27) were positively related to psychological pain, while family per-capita annual income (B15,000-30,000 = -2.52; B > 30,000 = -3.44), living arrangement (B With spouse = -3.40; B With children = -2.89; B Others = -3.82) and personal social capital (B BOC = -0.36) were negatively associated with psychological pain (p < 0.05). Moreover, for urban older people, gender (B Female = 0.98), current occupation (B With occupation = 1.13) and smoking (B yes = 2.14) were positively related to psychological pain, whereas age (B ≥ 80 = -1.45), family per-capita annual income (B > 30,000 = -3.63), living arrangement (B With spouse = -1.31), BMI (Bnormal = -2.62) and personal social capital (B BOC = -0.16) were negatively associated with psychological pain (p < 0.05). The present study sheds light on the worrying state of psychological pain experienced by Chinese older people. The results suggest that targeted interventions and social support, should be taken to alleviate the psychological pain among older people, especially urban older people.
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Affiliation(s)
- Han Zhou
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, 211200, China
| | - Dong Han
- Suqian Hospital of Nanjing Drum Tower Hospital Group, Suqian, 223800, China
| | - Haisen Zhou
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, 211200, China
| | - Xinfeng Ke
- School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Dongdong Jiang
- School of Public Health, Wuhan University, Wuhan, 430071, China
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, China
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Schroeder A, Wang N, Felson DT, Lewis CE, Nevitt MC, Segal NA. Knee Extensor and Flexor Torque Variability During Maximal Strength Testing and Change in Knee Pain and Physical Function at 60-Mo Follow-Up: The Multicenter Osteoarthritis Study (MOST). Am J Phys Med Rehabil 2021; 100:196-201. [PMID: 32932359 PMCID: PMC8024112 DOI: 10.1097/phm.0000000000001587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT As the population ages, there is a growing burden owing to musculoskeletal diseases, such as knee osteoarthritis, and subsequent functional decline. In the absence of a cure, there is a need to identify factors amenable to intervention to prevent or slow this process. The Multicenter Osteoarthritis Study cohort was developed for this purpose. In this study, associations between variability in peak knee flexor and extensor torque at baseline and worsening of pain and physical function over the subsequent 60 mos were assessed in a cohort of 2680 participants. The highest quartile of baseline knee flexor torque variability was found to be associated longitudinally with worsening pain (fourth quartile ß estimate, mean ± SE, 0.49 ± 0.19; P = 0.0115; with R2 = 0.28 and P for trend across quartiles = 0.0370) and physical function scores (fourth quartile ß estimate, mean ± SE, 1.39 ± 0.64; P = 0.0296; with R2 = 0.25 and P for trend across quartiles = 0.0371), after adjusting for baseline knee osteoarthritis and maximum knee flexor torque. There were no associations between baseline knee extensor torque and worsening pain or physical function by 60 mos. The presence of greater variability in maximum knee flexor strength may identify patients who may benefit from therapies aimed at preventing worsening knee pain and physical function.
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Affiliation(s)
- Allison Schroeder
- From the Department of PM&R, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (AS); Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, Massachusetts (NW); Boston University, Boston, Massachusetts (DTF); University of Alabama at Birmingham, Birmingham, Alabama (CEL); University of California, San Francisco, San Francisco, California (MCN); University of Kansas Medical Center, Kansas City, Kansas (NAS); and The University of Iowa, Iowa City, Iowa (NAS)
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Symptom Clusters, Functional Status, and Quality of Life in Older Adults With Osteoarthritis. Orthop Nurs 2015; 34:36-42; quiz 43-4. [DOI: 10.1097/nor.0000000000000112] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Luong MLN, Cleveland RJ, Nyrop KA, Callahan LF. Social determinants and osteoarthritis outcomes. AGING HEALTH 2012; 8:413-437. [PMID: 23243459 PMCID: PMC3519433 DOI: 10.2217/ahe.12.43] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Osteoarthritis (OA) is one of the most frequently occurring musculoskeletal diseases, posing a significant public health problem due to its impact on pain and disability. Traditional risk factors fail to account for all of the risk observed for OA outcomes. In recent years, our view of disease causation has broadened to include health risks that are created by an individual's socioeconomic circumstances. Early research into social determinants has focused on social position and explored factors related to the individual such as education, income and occupation. Results from these investigations suggest that low education attainment and nonprofessional occupation are associated with poorer arthritis outcomes. More recently, research has expanded to examine how one's neighborhood socioeconomic environment may be relevant to OA outcomes. This narrative review proposes a framework to help guide our understanding of how social context may interact with pathophysiological processes and individual-level variables to influence health outcomes in those living with OA.
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Affiliation(s)
- My-Linh N Luong
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, Chapel Hill, NC 27599, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Rebecca J Cleveland
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, Chapel Hill, NC 27599, USA
| | - Kirsten A Nyrop
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, Chapel Hill, NC 27599, USA
| | - Leigh F Callahan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, Chapel Hill, NC 27599, USA
- Departments of Medicine & Social Medicine, University of North Carolina at Chapel Hill, 333 South Columbia St, MacNider Hall, Chapel Hill, NC 27599, USA
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Pisters MF, Veenhof C, van Dijk GM, Heymans MW, Twisk JWR, Dekker J. The course of limitations in activities over 5 years in patients with knee and hip osteoarthritis with moderate functional limitations: risk factors for future functional decline. Osteoarthritis Cartilage 2012; 20:503-10. [PMID: 22330176 DOI: 10.1016/j.joca.2012.02.002] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 12/18/2011] [Accepted: 02/07/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the course of limitations in activities over 5 years follow-up and identify predictors of future limitations in activities in elderly patients with osteoarthritis (OA) of the hip or knee with moderate functional limitations. METHOD A longitudinal cohort study with 5 years follow-up was conducted. Patients (n=288) were recruited at rehabilitation centers and hospitals. The main outcome measures were self-reported and performance-based limitations in activities. Prognostic factors were demographic and clinical data, body functions, comorbidity, cognitive functioning, avoidance of activity and social support. Measurements were conducted at baseline, 1, 2, 3 and 5 years follow-up. RESULTS Both in patients with knee and hip OA, the course of limitations in activities remained fairly stable over a period of 5 years. Avoidance of activity, increased pain, more comorbidity, a higher age, a longer disease duration, a reduced muscle strength and range of joint motion at baseline predicted more future limitations in activities in patients with knee OA. In patients with hip OA, avoidance of activity, increased pain, more comorbidity, a higher age, a higher educational level and a reduced range of motion at baseline predicted more future limitations in activities. CONCLUSIONS The course of limitations in activities remains fairly stable over a period of 5 years in elderly patients with hip or knee OA. However, at individual level there is considerable variation. Predictors of more future limitations in activities include avoidance of activity, increased pain, higher morbidity count, reduced range of motion, and a higher age.
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Affiliation(s)
- M F Pisters
- Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.
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Vitality and the course of limitations in activities in osteoarthritis of the hip or knee. BMC Musculoskelet Disord 2011; 12:269. [PMID: 22111943 PMCID: PMC3236012 DOI: 10.1186/1471-2474-12-269] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 11/24/2011] [Indexed: 01/08/2023] Open
Abstract
Background The objective of the study was to determine whether psychological and social factors predict the course of limitations in activities in elderly patients with osteoarthritis of the hip or knee, in addition to established somatic and cognitive risk factors. Methods A longitudinal cohort study with a follow-up period of three years was conducted. Patients (N = 237) with hip or knee osteoarthritis were recruited from rehabilitation centers and hospitals. Body functions, comorbidity, cognitive functioning, limitations in activities and psychological and social factors (mental health, vitality, pain coping and perceived social support) were assessed. Statistical analyses included univariate and multivariate regression analyses. Psychological and social factors were added to a previously developed model with body functions, comorbidity and cognitive functioning. Results In knee OA, low vitality has a negative impact on the course of self-reported and performance-based limitations in activities, after controlling for somatic and cognitive factors. In hip OA, psychological and social factors had no additional contribution to the model. Conclusion Low vitality predicts deterioration of limitations in activities in elderly patients with osteoarthritis of the knee, in addition to established somatic and cognitive risk factors. However, the contribution of vitality is relatively small. Results of this study are relevant for the group of patients with knee or hip OA, attending hospitals and rehabilitation centers.
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Abstract
Osteoarthritis (OA) is now considered one of the ten most disabling diseases in developed countries and it is estimated that worldwide, 18% of women and 9.6% of men aged over 60, suffer from OA. It is, therefore, vital to take into consideration the demographics of this disorder, including the health needs of this age group and associated problems, such as reduced mobility or immobility and the inability to perform everyday tasks associated with chronic pain. Older patients, however, are sometimes able to accept their condition and adopt a positive outlook towards their OA as a coping strategy. This association with and acceptance of pain by the patient as a normal part of the ageing process may compromise the patient's ability to undertake activities of daily living and impact their psychological wellbeing.
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Affiliation(s)
- Rena Creedon
- School of Nusing and Midwifery, University College Cork, Ireland.
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van Dijk GM, Veenhof C, Spreeuwenberg P, Coene N, Burger BJ, van Schaardenburg D, van den Ende CH, Lankhorst GJ, Dekker J. Prognosis of Limitations in Activities in Osteoarthritis of the Hip or Knee: A 3-Year Cohort Study. Arch Phys Med Rehabil 2010; 91:58-66. [DOI: 10.1016/j.apmr.2009.08.147] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 06/21/2009] [Accepted: 08/28/2009] [Indexed: 01/22/2023]
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van Dijk GM, Dekker J, Veenhof C, van den Ende CHM. Course of functional status and pain in osteoarthritis of the hip or knee: a systematic review of the literature. ACTA ACUST UNITED AC 2006; 55:779-85. [PMID: 17013827 DOI: 10.1002/art.22244] [Citation(s) in RCA: 171] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To systematically review studies describing the course of functioning in patients with osteoarthritis (OA) of the hip or knee and identifying potential prognostic factors. METHODS A systematic search was performed. Studies involving patients with hip or knee OA, >6 months of followup, and outcome measures on functional status or pain were included. Methodologic quality was assessed using a standardized set of 11 criteria; a qualitative data analysis was performed. RESULTS Approximately 6,500 titles and abstracts were screened and 48 publications were considered for inclusion. Eighteen studies, 4 of which met the high methodologic quality criteria, were included. For hip OA, there was limited evidence that functional status and pain do not change during the first 3 years of followup. After 3 years, however, a worsening of functional status and pain was seen. For knee OA, there was conflicting evidence for the first 3 years and limited evidence for worsening of pain and functional status after 3 years. Furthermore, limited evidence was established for negative associations between future functional status and laxity, proprioceptive inaccuracy, age, body mass index, and knee pain intensity. In contrast, greater muscle strength, better mental health, better self-efficacy, social support, and more aerobic exercise were protective factors in the first 3 years. CONCLUSION Pain and functional status in hip or knee OA seem to deteriorate slowly, with limited evidence for worsening after 3 years of followup. In specific subgroups, prognosis in the first 3 years of followup was either worse or better, as both risk factors and protective factors were identified. Prognostic factors included biomechanical factors, psychological factors, clinical factors, and treatment modalities. To strengthen the evidence, further high-quality longitudinal research on hip or knee OA functioning is needed.
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Rosemann T, Joos S, Koerner T, Szecsenyi J, Laux G. Comparison of AIMS2-SF, WOMAC, x-ray and a global physician assessment in order to approach quality of life in patients suffering from osteoarthritis. BMC Musculoskelet Disord 2006; 7:6. [PMID: 16438717 PMCID: PMC1382223 DOI: 10.1186/1471-2474-7-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2005] [Accepted: 01/26/2006] [Indexed: 11/13/2022] Open
Abstract
Background Chronic diseases like osteoarthritis (OA) substantially affect different dimensions of quality of life (QoL). The aim of the study was to reveal possible factors which mainly influence general practitioners (GPs) assessment of patients' QoL. Methods 220 primary care patients with OA of the knee or the hip treated by their general practitioner for at least one year were included. All GPs were asked to assess patients' QoL based on the patients' history, actual examination and existing x-rays by means of a visual analog scale (VAS scale), resulting in values ranging from 0 to 10. Patients were asked to complete the McMaster Universities Osteoarthritis Index (WOMAC) and the Arthritis Impact Measurement Scale2 Short Form (AIMS2-SF) questionnaire. Results Significant correlations were revealed between "GP assessment" and the AIMS2-SF scales "physical" (rho = 0.495) and "symptom" (rho = 0.598) as well as to the "pain" scale of the WOMAC (rho = 0.557). A multivariate ordinal regression analysis revealed only the AIMS2-SF "symptom" scale (coefficient beta = 0.2588; p = 0.0267) and the x-ray grading according to Kellgren and Lawrence as significant influence variables (beta = 0.6395; p = 0.0004). Conclusion The results of the present study suggest that physicians' assessment of patients' QoL is mainly dominated by physical factors, namely pain and severity of x-ray findings. Our results suggest that socioeconomic and psychosocial factors, which are known to have substantial impact on QoL, are underestimated or missed. Moreover, the overestimation of x-ray findings, which are known to be less correlated to QoL, may cause over-treatment while important and promising targets to increase patients' QoL are missed.
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Affiliation(s)
- Thomas Rosemann
- Department of General Practice and Health Services Research, University of Heidelberg, Voβstr. 2, 69115 Heidelberg, Germany
| | - Stefanie Joos
- Department of General Practice and Health Services Research, University of Heidelberg, Voβstr. 2, 69115 Heidelberg, Germany
| | - Thorsten Koerner
- Department of General Practice and Health Services Research, University of Heidelberg, Voβstr. 2, 69115 Heidelberg, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, University of Heidelberg, Voβstr. 2, 69115 Heidelberg, Germany
| | - Gunter Laux
- Department of General Practice and Health Services Research, University of Heidelberg, Voβstr. 2, 69115 Heidelberg, Germany
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Abstract
BACKGROUND A goal of many public policies in support of older Americans is independence, but the meaning of independence in the context of community-dwelling elders is not clear. OBJECTIVE To create a preliminary conceptual model of independence for older, community-dwelling Americans. METHODS Exploratory factor analysis was used during secondary analysis of a federal dataset, the Second Supplement on Aging (N = 9,447). After preparation of the dataset, 51 variables were selected for possible submission to factor analysis. Initial item reduction resulted in 21 variables for factor structure development. RESULTS Three factors for a preliminary conceptual model of independence were identified: physical function, social ability, and physical health. Physical function, explaining 29.5% of the variance, included variables related to elders' ability to function in everyday life, such as how well they function in their homes. Social ability variables included items related to social activities, education, driving, and leaving the house, and accounted for 8.6% of the variance. Physical health explained 6.1% of the variance and included variables related to visits to the doctor, prescription drug use, and number of days spent in bed during the past year. DISCUSSION Findings suggest the importance of physical function for independence and the importance of a physical environment that supports various levels of physical function. Social ability plays a role in independence and may require adequate physical function, financial and material resources, and social support. Physical health may be a component of physical function or reflect access to healthcare. Future studies using primary data are indicated for further development of the concept of independence in the context of community-dwelling elders in the United States. A conceptual model of independence will guide nurses in their assessments of and interventions for older, community-dwelling adults and will help policymakers prioritize spending for programs that have independence as a goal.
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Affiliation(s)
- Margaret W Baker
- Department of Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, Seattle, WA 98195, USA.
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